GAN

ThS. BS NGUYEN HOANG VU

BM. GIAI PHAU
KHOA Y H Y DC TPHCM

6:13 PM

ThS.BS. NGUYEN HOANG VU

AI CNG

Tang ac

O bung

Rat nhieu chc nang: Tao mat, giai oc,

tham gia ieu hoa ng mau,

6:13 PM

ThS. BS. NGUYEN HOANG VU

V TR

O bung, di c hoanh, tang tren mac

treo ket trang ngang, o di hoanh phai
lan sang thng v.
Thong thng, c che bi cac xng
sn, ch s c mot phan thng v.
( tre nho co the s thay gan vung ha
sn phai)

6:13 PM

ThS. BS. NGUYEN HOANG VU

6:13 PM

ThS. BS. NGUYEN HOANG VU

HNH THE NGOAI VA LIEN QUAN

MAT HOANH:

4 phan

Phan tren:

Loi, ngay di c hoanh

Phan trc:

Tiep xuc c hoanh va thanh

bung trc
Day chang liem.

Phan phai:
Phan sau:
6:13 PM

Xng sn, ngach mang phoi

phai, mot phan ay phoi phai
Co TM chu di

ThS. BS. NGUYEN HOANG VU

Day chang vanh

Day chang liem

Mat hoanh cua gan: Phan trc

6:13 PM

ThS. BS. NGUYEN HOANG VU

Mat hoanh: phan tren

6:13 PM

ThS. BS. NGUYEN HOANG VU

Mat hoanh: Phan sau

6:13 PM

ThS. BS. NGUYEN HOANG VU

MAT TANG: Hng xuong di va ra

trc, lien quan vi cac tang trong o
bung.
Co cac ranh sau:
Ranh doc phai: Do ho tui mat (pha trc)

va ranh TM chu di (pha sau).

Ranh doc trai: Khuyet day chang tron gan

(pha trc) va khe day chang TM (pha

sau)

Ranh ngang: Ca gan

6:13 PM

ThS. BS. NGUYEN HOANG VU

Mat tang cua gan

6:13 PM

ThS. BS. NGUYEN HOANG VU

10

CAC DAY CHANG VA

PHNG TIEN CO NH GAN
Tnh mach chu di: Pha sau; cac TM gan o

vao TM chu di.

Day chang hoanh gan: Noi gan vi c

hoanh.

Day chang vanh: la phuc mac, noi t gan len

c hoanh.

Day chang tam giac phai va trai: la phuc mac,

hai au cua day chang vanh.

6:13 PM

ThS. BS. NGUYEN HOANG VU

11

 Day chang liem: la phuc mac, treo gan vao c

hoanh va thanh bung trc, con goi la day

chang treo gan.

Mac noi nho: la phuc mac, noi gan vi

b cong nho cua da day va ta trang.

D/c gan v
D/c gan ta trang
Day chang tron gan: Do TM ron tac lai va x

hoa, noi t ron en mat tang cua gan

Day chang TM

6:13 PM

ThS. BS. NGUYEN HOANG VU

12

Day chang vanh

Day chang liem

Mat hoanh cua gan: Phan trc

6:13 PM

ThS. BS. NGUYEN HOANG VU

13

6:13 PM

ThS. BS. NGUYEN HOANG VU

14

6:13 PM

ThS. BS. NGUYEN HOANG VU

15

CAU TAO VA HNH THE TRONG

BAO GAN: Gom hai lp:
Lp thanh mac: ngoai, la la tang phuc mac.
Lp x: trong, gia lp thanh mac va mo
gan; i cung mach mau va ong mat vao mo
gan tao nen bao x quanh mach.
MO GAN:
TE BAO GAN + MACH MAU + NG MAT
6:13 PM

ThS. BS. NGUYEN HOANG VU

16

TM gan
TM trung tam
tieu thuy

BO BA:

M gan
TM ca
Ong mat

6:13 PM

ThS. BS. NGUYEN HOANG VU

17

6:13 PM

ThS. BS. NGUYEN HOANG VU

18

6:13 PM

ThS. BS. NGUYEN HOANG VU

19

6:13 PM

ThS. BS. NGUYEN HOANG VU

20

S PHAN THUY CUA GAN

THEO HNH THE NGOAI:
THEO NG MACH MAT:

6:13 PM

ThS. BS. NGUYEN HOANG VU

21

6:13 PM

ThS. BS. NGUYEN HOANG VU

22

MACH VA THAN KINH

ONG MACH:

M THAN TANG
M GAN CHUNG
M GAN RIENG

M GAN PHAI

M GAN TRAI

M tui mat
6:13 PM

ThS. BS. NGUYEN HOANG VU

23

TNH MACH:
gan co hai he tnh mat: TM gan va TM ca.
Tnh mach gan:
Bat au t TM trung tam tieu thuy, o ve ba
TM gan (con goi la TM tren gan) sau cung o
ve TM chu di

6:13 PM

ThS. BS. NGUYEN HOANG VU

24

Tnh mach ca: mau tnh mach t ong tieu

hoa, tuy, lach, khong o trc tiep ve
TM chu di ma o ve gan bang he
thong TM ca. Gan nhan mau t TM
ca e loc cac chat oc roi o ve TM
chu di bang cac TM gan.

6:13 PM

ThS. BS. NGUYEN HOANG VU

25

TM lach va TM mac treo trang tren hp thanh

TM ca. TM lach con nhan mau t TM mac treo
trang di. TM tui mat, TM v phai va TM v trai
o trc tiep vao TM ca.
TM ca i trong mac noi nho (cung M gan
rieng va ong mat chu) vao ron gan (TM ca
sau nhat). en ron gan, TM chia hai nhanh phai
va trai e vao na gan phai va na gan trai.

6:13 PM

ThS. BS. NGUYEN HOANG VU

26

Vong noi CA CHU

He TM ca va he TM chu co s thong noi nhau
ben ngoai gan. Khi ap lc TM ca tang co the
gay v cac TM tai vong noi nay
HE CA

HE CHU

TM v trai

TM thc quan
Vong noi
thc quan

Chay mau thc quan trong benh x gan

6:13 PM

ThS. BS. NGUYEN HOANG VU

27

HE CHU

HE CA

TM trc trang gia

TM trc trang di

TM trc trang tren

Vong noi
trc trang
Chay mau trc trang trong benh x gan
6:13 PM

ThS. BS. NGUYEN HOANG VU

28

6:13 PM

ThS. BS. NGUYEN HOANG VU

29

NG DAN MAT NGOAI GAN

1.ONG GAN:
TB gan tiet mat o vao tieu quan mat, sau o
o vao ong gan phai va ong gan trai. Ong gan
(P) va ong gan (T) hp thanh ong gan chung.
Ong gan chung chay en b tren ta trang
nhan ong tui mat tao thanh ong mat chu.

6:13 PM

ThS. BS. NGUYEN HOANG VU

30

2.ONG MAT CHU:

T b tren ta trang, i xuong pha sau phan
tren (D1) ta trang, en mat sau au tuy roi o
vao nhu ta ln. (Xem bai tuy va ta trang).
Ong mat chu dai khoang 5 6cm, ng
knh trung bnh 5 6mm, ni hep nhat khoang
3mm (tai bong gan tuy).

6:13 PM

ThS. BS. NGUYEN HOANG VU

31

Ong mat chu c chia 4 oan:

oan

tren ta trang: trong cuong gan,

ben trai la M gan rieng, pha sau la TM
ca.

oan

sau ta trang:

oan

sau tuy:

oan

trong thanh ta trang: hep nhat

6:13 PM

ThS. BS. NGUYEN HOANG VU

32

6:13 PM

ThS. BS. NGUYEN HOANG VU

33

Ong mat
chu

Thanh ta
trang
Ong tuy
chnh

C vong Oddi

Tuoi cang ln ong mat chu cang dan

6:13 PM

ThS. BS. NGUYEN HOANG VU

34

3.TUI MAT:
Co ac va d tr mat.
Nam trong ho tui mat (ging tui mat). Ging
tui mat khong co phuc mac phu.
Ba phan: ay, than , co tui mat. ay tui mat
nam tai iem giao nhau gia b sn phai va
b ngoai c thang bung (iem Murphy)

6:13 PM

ThS. BS. NGUYEN HOANG VU

35

4.ONG TUI MAT: dan mat rt tui mat ra

ong mat chu

6:13 PM

ThS. BS. NGUYEN HOANG VU

36

ong gan chung

ong mat chu

ong tui mat

6:13 PM

ThS. BS. NGUYEN HOANG VU

37

6:13 PM

ThS. BS. NGUYEN HOANG VU

38

Hnh anh sieu am mot trng hp soi tui mat

6:13 PM

ThS. BS. NGUYEN HOANG VU

39

Hnh anh sieu am mot trng hp soi ket

co tui mat tui mat
6:13 PM

ThS. BS. NGUYEN HOANG VU

40

Cam n!
6:13 PM

ThS. BS. NGUYEN HOANG VU

41